Tuesday, September 10, 2013

When Eating Is A Solution and Not a Problem

Act #253:  There's always more beyond the surface.

Once upon a time back in 1985, there was a dashing, innovative physician named Vincent Felitti who worked for Kaiser Permanente's Prevention Medicine department and oversaw an obesity weight-loss clinic in San Diego, California.  People who were 100 - 600 pounds came from all over the world to be a part of his clinic.  Although the program was very successful, Dr. Felitti couldn't figure out why every year, over a five-year period, half of the participants dropped out - that is, 50% of participants never came back, even during the peak of their weight loss.  So he began digging.  He called up about 286 of those participants and asked them a series of questions:  How much did you weigh when you entered high school?  How old were you when you got married?  How old were you when you had your first sexual experience?   But he found nothing, no clarity about why people were dropping out.  Then one day, after interviewing several former participants, he mistakenly reworded one of his questions and asked, "How much did you weigh when you first became sexually active?"  The female participant looked at him and responded, "40 pounds."  Dr. Felitti, thinking that the participant clearly misunderstood him, repeated the question.  And that's when the female participant broke down and revealed that she was 4 years old the first time she was sexually molested by a family member.  Dr. Felitti went on to discover that almost all of the 286 people he called back had also experienced childhood sexual trauma.  To these participants,  eating was a fix, a solution.  It made them feel better, soothed their anxiety, fear, anger or depression - just like alcohol or drugs. When they weren't eating, their anxiety, stress, and fear levels were intolerable.  In many cases the weight also served as protection, made them feel safe and invisible - a means to keep the sexual abuse away.  

In 1995, Dr. Robert Anda of the Center for Disease Control (CDC) partnered with Kaiser Permanente and expanded the research to cover 17,421 participants who were followed for 15 years.  The study examined eight types of trauma (including three types of abuse — sexual, verbal and physical) and five types of family dysfunction (a parent who’s mentally ill or alcoholic, a mother who’s a domestic violence victim, a family member who’s been incarcerated, a loss of a parent through divorce or abandonment). Emotional and physical neglect were later added, for a total of 10 types of adverse childhood experiences (ACE). 

The results of the ACE Study were astounding.  There was a direct link between childhood trauma and adult onset of chronic disease, as well as mental illness, doing time in prison, and even work issues, such as absenteeism.  About two-thirds of the adults in the study had experienced one or more types of adverse childhood experiences. Of those, 87 percent had experienced 2 or more types. 

What does this mean?  This means that children affected by childhood trauma will likely struggle throughout their lifespan and will experience behavioral, learning, social, criminal, and chronic health problems.  Many will end up in "the system".  Bu what do we do as a society?  We call child protective services, stick them in foster care, and send them to alternative school - all worthy and critical services, but we simply don't do enough to address the root of the problem.  We invest little in preventing the trauma from happening in the first place, or fully treating the trauma itself.  

What do we do as individuals?  We silently judge and ridicule that woman who has no self-control, who is too large to even get around.  Next time your mind goes there, remember that just like you, she might have a story.  And that a long time ago, she once weighed only 40 pounds.

For more information about the ACE Study, please visit:  http://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

1 comment:

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